Appointments can be made to visit with our dogs Monday-Saturday from 10-4. What days and times work best for you? *

Name (First & Last) *

Address *

City *

State *

Zip Code *

Phone Number *

Are you 18 years of age or older? *

Is there a specific animal you are interested in adopting from HSAR? If so, please indicate the animal’s name. *

Do you rent or own your home? Is it an apartment or house? *

Landlord's name and phone number (we require landlord approval): *

Do you have a fenced in yard? If so, what type of fence and how high is it? *

What pets do you currently have in your household? For each, please give us the following information: Type (dog, cat, etc.), age, gender, whether the animal is altered, and whether it is an indoor pet, outdoor pet, or both. *

Other than the pets you currently have, what other pets have you had in the last 5 years? Please tell us the type of each animal and what happened to them.

Describe your dog’s life. Where will he/she stay? How will he/she exercise, socialize, and interact with you? Where will he/she sleep? *

How many hours will the dog be alone during the day? *

What are the main reasons you would like to get a dog? (house pet, guard dog, companion, gift, companion for another dog, or other?) *

Is the whole family in agreement with adopting a rescue pet? *

Do you have children? If so, what are their ages? *

Does anyone in your home have pet allergies? *

What will you do if your new dog chews your belongings or shows other destructive behavior? *

Are you likely to enroll your dog in obedience training? *

How long do you feel an animal should be given for an adjustment period? *

Are you willing to work with a new pet on any issues he or she may have? *

What behaviors would be unacceptable to you? *

What actions would you take to correct these behaviors? *

Would you allow us to visit your home? *

Who is your vet and may we contact them for a reference? *

Have you ever dropped off a pet at a shelter? If so, what were the circumstances? *

Where did you hear about this animal? HSAR website, Petfinder, Petco, KOLO 8, Newspaper ad (which paper?), other (if so where?) *